Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review.

The incidence of early-onset colorectal cancer (younger than 50 years) is rising globally, the reasons for which are unclear. It appears to represent a unique disease process with different clinical, pathological, and molecular characteristics compared with late-onset colorectal cancer. Data on oncological outcomes are limited, and sensitivity to conventional neoadjuvant and adjuvant therapy regimens appear to be unknown. The purpose of this review is to summarize the available literature on early-onset colorectal cancer. Within the next decade, it is estimated that 1 in 10 colon cancers and 1 in 4 rectal cancers will be diagnosed in adults younger than 50 years. Potential risk factors include a Westernized diet, obesity, antibiotic usage, and alterations in the gut microbiome. Although genetic predisposition plays a role, most cases are sporadic. The full spectrum of germline and somatic sequence variations implicated remains unknown. Younger patients typically present with descending colonic or rectal cancer, advanced disease stage, and unfavorable histopathological features. Despite being more likely to receive neoadjuvant and adjuvant therapy, patients with early-onset disease demonstrate comparable oncological outcomes with their older counterparts. The clinicopathological features, underlying molecular profiles, and drivers of early-onset colorectal cancer differ from those of late-onset disease. Standardized, age-specific preventive, screening, diagnostic, and therapeutic strategies are required to optimize outcomes

Post-Operative Functional Outcomes in Early Age Onset Rectal Cancer

Background: Impairment of bowel, urogenital and fertility-related function in patients treated for rectal cancer is common. While the rate of rectal cancer in the young (<50 years) is rising, there is little data on functional outcomes in this group. Methods: The REACCT international collaborative database was reviewed and data on eligible patients analysed. Inclusion criteria comprised patients with a histologically confirmed rectal cancer, <50 years of age at time of diagnosis and with documented follow-up including functional outcomes. Results: A total of 1428 (n=1428) patients met the eligibility criteria and were included in the final analysis. Metastatic disease was present at diagnosis in 13%. Of these, 40% received neoadjuvant therapy and 50% adjuvant chemotherapy. The incidence of post-operative major morbidity was 10%. A defunctioning stoma was placed for 621 patients (43%); 534 of these proceeded to elective restoration of bowel continuity. The median follow-up time was 42 months. Of this cohort, a total of 415 (29%) reported persistent impairment of functional outcomes, the most frequent of which was bowel dysfunction (16%), followed by bladder dysfunction (7%), sexual dysfunction (4.5%) and infertility (1%). Conclusion: A substantial proportion of patients with early-onset rectal cancer who undergo surgery report persistent impairment of functional status. Patients should be involved in the discussion regarding their treatment options and potential impact on quality of life. Functional outcomes should be routinely recorded as part of follow up alongside oncological parameters

Ownership illusions in patients with body delusions: : Different neural profiles of visual capture and disownership

© 2016 The Authors. Published by Elsevier Ltd. This is an open access article under the CCBY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) funded by European Research Council. The version of record, Martinaud, O., et al., 'Ownership illusions in patients with body delusions: Different neural profiles of visual capture and disownership,' Cortex, Vol 87, Special Issue, pp. 174-185, first published online 19 October 2016, is available online at doi: http://dx.doi.org/10.1016/j.cortex.2016.09/025The various neurocognitive processes contributing to the sense of body ownership have been investigated extensively in healthy participants, but studies in neurological patients can shed unique light into such phenomena. Here, we aimed to investigate whether visual capture by a fake hand (without any synchronous or asynchronous tactile stimulation) affects body ownership in a group of hemiplegic patients with or without disturbed sensation of limb ownership (DSO) following damage to the right hemisphere. We recruited 31 consecutive patients, including seven patients with DSO. The majority of our patients (64.5% overall and up to 86% of the patients with DSO) experienced strong feelings of ownership over a rubber hand within 15 sec following mere visual exposure, which correlated with the degree of proprioceptive deficits across groups and in the DSO group. Using voxel-based lesion-symptom mapping analysis, we were able to identify lesions associated with this pathological visual capture effect in a selective fronto-parietal network, including significant voxels (p < .05) in the frontal operculum and the inferior frontal gyrus. By contrast, lesions associated with DSO involved more posterior lesions, including the right temporoparietal junction and a large area of the supramarginal gyrus, and to a lesser degree the middle frontal gyrus. Thus, this study suggests that our sense of ownership includes dissociable mechanisms of multisensory integration.Peer reviewedFinal Published versio

Circadian variation in shedding of the oocysts of Isospora turdi (Apicomplexa) in blackbirds (Turdusmerula): an adaptative trait against desiccation and ultraviolet radiation. Int J Parasitol 39: 735–739. doi

a b s t r a c t Many parasite species spend part of their life cycle in the external environment waiting for a new host. Emergence of parasites often occurs once a day, which may help to minimise mortality in an inhospitable environment and increase transition rates. Many intestinal parasites in birds are released in faeces only in the late afternoon. However, the adaptative significance of this pattern is unclear. One hypothesis is that a particular time of emergence may prevent parasite desiccation and therefore increase the parasite&apos;s life expectancy in the external environment. We tested this hypothesis experimentally using the blackbird (Turdus merula) infected with Isospora turdi (Protozoa: Apicomplexa). We found that short exposure of faeces to natural sunlight has a dramatic effect on oocyst survival. This appears to be due to the effect of warmth and ultraviolet (UV) radiation with UVB waves being more damaging than UVA. Oocysts contained in faeces shed in water are protected from the effect of sunlight. Together, these results suggest that the release of oocysts in the late afternoon is an adaptative trait to avoid desiccation and UV radiation, thus reducing mortality of the oocysts in the external environment.

Circadian variation in shedding of the oocysts of Isospora turdi (Apicomplexa) in blackbirds (Turdus merula): an adaptative trait against desiccation and ultraviolet radiation.

5 pagesInternational audienceMany parasite species spend part of their life cycle in the external environment waiting for a new host. Emergence of parasites often occurs once a day, which may help to minimise mortality in an inhospitable environment and increase transition rates. Many intestinal parasites in birds are released in faeces only in the late afternoon. However, the adaptative significance of this pattern is unclear. One hypothesis is that a particular time of emergence may prevent parasite desiccation and therefore increase the parasite's life expectancy in the external environment. We tested this hypothesis experimentally using the blackbird (Turdus merula) infected with Isospora turdi (Protozoa: Apicomplexa). We found that short exposure of faeces to natural sunlight has a dramatic effect on oocyst survival. This appears to be due to the effect of warmth and ultraviolet (UV) radiation with UVB waves being more damaging than UVA. Oocysts contained in faeces shed in water are protected from the effect of sunlight. Together, these results suggest that the release of oocysts in the late afternoon is an adaptative trait to avoid desiccation and UV radiation, thus reducing mortality of the oocysts in the external environment